Such a fucking mess!

[IrianOfW]

Dad is in hospital at the moment. He went into have bladder stones removed. He has Parkinsons and is almost entirely deaf. He's 87. He's now been in there for 11 days, has some sort of infection that they can't diagnose, had a fall (not the nurses's fault at all). My brother stayed with my mum for 6 days when he went into hospital expecting dad to come out after 3 days as was expected. DBro had to go home. Meanwhile my mum had a fall and has hurt her very arthritic hip to the extent that she is finding getting about is difficult. When she visits dad she had to park at the other end of the site and walk which is almost impossible for her. I have been in to see dad many times since he had been in, with and without mum.

I arranged for someone to come and discuss care for my dad at home when he is released. Apparently money isn't an option according to my dad but I am not sure if he realises how much it will cost. And of course now my mum is more or less hors de combat.

I have a full-time job, a depressed DH, a 22 year old son suffering from GAD and a 16 year old on the autistic spectrum approaching his GCSEs.

i don't know what to do or where to turn.

Help!

Hi OP, the six week package that shining star2 refers to above is called re-ablement care, or was in my part of England - I got this for my mum a few years ago on her discharge from hospital and it is free to everyone, in a way that long term care isn't and involves a financial assessment. So ask for this tonight - say that your dad will need this to be discharged as there is no one at home who can look after him. He will need to be assigned a social worker but it's the hospital you need to press on this - it's in their interests to make sure they can discharge patients, but safely - it's no good for anyone if the patient 'bounces back' and is readmitted. I was in a similar position in that my dad was there but not up to caring for my mum to the extent she needed, I worked FT and had DC to look after and lived too far away - but you have to make this clear to the authorities. My mum also spent a few weeks in a nursing home between hospital and going home - ask for this too as it's a good bridging option, and again if the hospital decide on it you don't get charged.

In England the discharge team have to assess their needs to allow them to go home. If he's in need of continuing care for medical reasons they should assess him (ask for an assessment for nhs continuing care) and the care will be supplied free of charge if he qualifies but you can choose a care company from the approved list or ask for a personal budget and hire your own (I've done this so pm me for advice if needed). It all comes down to points on a needs analysis so ensure pride doesn't get in the way!

Sorry, just to clarify a point in my post above - I meant that long term care involves a financial assessment. Re-ablement care doesn't and there's no charge. You just get it if needed. It's definitely what you need for starters OP.

Thanks all of you. Life savers xx

Have messaged you with a recommendation for slightly better value private carers if that helps

I'm a stuck record on this subject but my advice before you let your Dad within sniffing distance of a care home, respite or other, is to get LPA in Health and Welfare. Download the form off the website, get the signatures (in the right order) and pay the £100 or so fee. Do it now, it takes weeks to process but failure to do so and Social Services can assume legal control of his care.

Yes, supposedly only when he's lost mental capacity, but that can be a nebulous area, and it works to the Council's advantage to misdiagnose any urinary tract infection as dementia. If he deterioates in a care home due to poor care, that's their chance - never imagine the Council will say 'Oh, you're right, he'd be better off at home!' They will instead act according to his 'best interests' - which translates as doing whatever the hell they want.

If he's got loads of cash, so much the better! They can keep him in any care home, respite be damned, as long as they want to keep him forking out £1.5K a week, week in week out. They can overule you in that situation - you don't have LPA, remember? He didn't grant it to you, presumably because you are a nasty, feckless daughter. Yes, I know you don't think that but how can you prove otherwise?

And research care homes anyway best you can - the CQC is corrupt, so don't expect much from them, they often sit on damning care home reviews for eight months while the body count mounts up. Try word of mouth but if your dad needs nursing care, the options will be more limited.
As he has Parkinson's, watch out for anyone placing him on covert end-of-life care though this is unlikely if he can still talk and engage conversationally. That said, some NHS CCGs have been known to jump the gun.

Thanks for the advice newspaper. Good stuff. Not considering a care home right now but I am forewarned.

Guess what! Mum has been admitted with a suspected broken hip.

Oh no! How terrible, how is she in herself?

Very positive. She has been in so much pain recently she is just happy to be getting help

Sometimes having two in hospital is better than just one. Obviously it is worrying but for a short period you know they are safe, have people in attendance and you can sleep more soundly.
Gives you a little bit of respite time to catch up with your own immediate family. This might sound tough but don't over visit them and let the nursing teams take over while you catch your breath

And meant to add that they will be escalated to a more urgent position on the social worker's list now that the two cases are more 'visible'. Not saying discharge will be easy but the worsened situation actually should go in their favour.

Never admit to the full extent of what you are able and willing to do, because this will be taken as a starting point and the burden will just increase. You need to save your energy for the things only you can do - help with information and assist in decisions, and moral support, social interaction and just being a daughter.

As others have said - dig out the discharge team at the hospital - their focus is freeing beds so they will work hard at getting things moving. Try to get an early assessment - use words like "Can't ensure safety at home" "risk of early readmission". Look for a re-ablement package, up to 4 visits a day, for up to 6 weeks, free and non-means tested - though it will be cut short if they decide he has continuing care needs.

As someone said - don't over-visit. You need to have someone to visit to pick up/deliver laundry and provide biscuits and anything else they need. But otherwise they're in good hands and you will find that life gets amazingly busy and complicated on discharge, so build up your energy. By all means phone the ward for progress reports just to remind them that this particular oldie has family rooting for them. Say "yes" to any friends' offers of visits, and get them to take stuff in and to collect.

Long term care at home is means tested. If more than £23000 in savings then they pay; if less then £23000, then they pay if their income is too high. If their savings are in joint names, it's worth persuading them to split - someone on here has had trouble - not the actually figures but an example to show the problem: savings started at, say £50k joint, so £25k belonging to the person needing care. But when they'd spent £2k on his care, so he had less than £23 left, Council still regarded the remaining £48k as split equally rather than 25/23, so still demanded he pay.

Care at home can't take the value of the house into account, so it is just savings over and above that that they look at.

Definitely apply for attendance allowance. he continuing nursing care is harder to get but again consider.

Regarding POA - i would advise you to get them in place for both financial affairs and health as your parents are elderly. Dont wait for a crisis as this will be too late and they take 2-3 months to be fully registered. The most difficult part is getting all the signatures in place, and witnessed.

I would also advise getting Power of Attorney, both legal and health, in place for both your parents now. Far better to have it before you need it, than to not be able to get it. I can recommend a MNer who is a solicitor who works remotely, and who did mine by phone and post contact to save running round. PM me if you want details.

Hi Op I’ve only read as far as wigglies advice but just to say 6 weeks reablement care for dad is free of charge.

Oh Mere has it all clearly set out

Plus lots of framed photos and family presence around hospital bed, to make a point.
When you arrive, arrive with some drink, either tea or Lipton's Peach Tea is good, not too acidic. Maybe even install a small fridge in the room if there is one for the long haul, or beside their bed. Ask first, obv, but a nice cool drink is great on a warm or hot ward.
Get a fan, and btw a broken hip leads to hip replacement at that age.

Any whiff of nonsense from hospital staff, anything sly or catty and that is a very bad sign. In such circs, guile is your friend and anger is not - you'll get the 'anger and intimidation' charge and can be barred or have visits restricted. I am not suggesting you look forward to this, it may never happen, but it has been known to happen.

Anything important and get it in writing or put it in writing - or it never happened, you'll later find, you have no record of it.

It's not outwith the realms of fantasy that both DM and DF leave together to a place of temporary respite organised by the hospital / social work team involved. My DM had only two nights in hospital when she broke her hip. She was returned care home when it was established her dementia meant physio would not work as she could not take instruction. If they could be kept together everyone would benefit.

Hi all

sorry for the late reply but as you can imagine I have been a bit busy.

They are both home now - mum did not break the hip just severe internal bruising - v painful.

I was staying at their home from Wednesday to Saturday evening. Dad came out on Thursday, mum came out on Friday. TBH it's been a bit of a nightmare and I am totally wrung out...but they are home, comfortable, safe and getting better. They have a carer coming in twice a day to get dad up and dressed and then washed and ready for bed. I have been preparing meals for them - today is the first day I won't be but there are some ready meals.

No care was provided for them at home by the hospital but dad will get follow-up physio for a few months at home.

I discovered that I have power of attorney and have had since 2000! I don't remember signing anything but clearly I did. I had a very small DD at the time so I guess I was in fog.

Thanks for all the advice.

I discovered that I have power of attorney and have had since 2000!

I that case it is an Enduring Power of Attorney (EPA), not a Lasting Power of Attorney (LPA) and will only be for legal and financial, not health & welfare,. You will need to register it with the Office of the Public Guardian before you can use it. I think (!) it can only be registered when they have lost capacity, which is rather bizarre as I think they have to sign it. It's also worth doing a health and welfare LPA so that you have some say over their treatment etc.
Can you tell I've been there, done that? I knew we had an EPA but had no idea things had changed & that it didn't cover health & welfare.
Please check the details as I may be mis-remembering some of it.

Age UK information about LPA & EPA

I would def sort POA out for health and finance for both of them - you can have ones that cite each other and or another person

I am in similar sitch at mo Dad just out of Hospital the double failed grafts on bypass surgery and one working artery, plus gallstones, plus diabetic (insulin dependant) plus a shed load of other shit health issues. Mum is moderate dementia with her own health issues. We are trying to provide respite for my Dad who is my Mums carer. I am 2.hr 15 away by car and nearer 3hrs by train. My sister is covering alot (too much really) me as well and another sister due for Easter hols. Brothers have also been helping but also hindering lol.

All I can say is badger he staff on the ward to get an assessment done for your dad coming home, talk about aids, help needed in the house and care as well. They should have a team there that do the assessments and come out to him. As to your Mum has she been seen after her fall?? It is possible to get temporary blue badges with a GPs sign off, so your Mum could apply for herself as well as your Dad (My parents both have one and its frankly a godsend). Your Mum will be feeling particularly vulnerable at the moment to be fair as she will be frustrated about what she can't do. I would take her in to visit and drop her at the door before parking - chairs can also be used for visitors as well.

Oh a point - check the ready meals for being freezable - we found not all are...

RB68 they are both already home - read the OP's update!

Have you had contact with your Occupational Therapy department? I have a friend who's a community OT and they can assess if there is anything to be done to make living at home safer (adaptations). My friend works with all kinds of people, but often gets referrals after falls, or to people who have conditions like MS and Parkinson's which can affect balance etc.

You might already have them involved, but if not their GP is the place to start.